Sangamo Therapeutics is set to expand its cell and gene therapy pipeline through the acquisition of Valbonne, France-based TxCell for €72 million ($84.5 million). If Sangamo's plans to initiate clinical trials in 2019 of TxCell's immunotherapy product TX200—which uses engineered regulatory T (Treg) cells—are successful, then this will be the first therapy of this kind to enter the clinic. TX200 is based on the same chimeric antigen receptor (CAR) technology used to produce antigen-specific T cells for the spectacularly successful CAR-T therapies for treating B-cell malignancies. Whereas CAR-T engineers cytotoxic T cells to destroy target cells, CAR-Treg cells protect the target from immune attack and so could be useful in treating autoimmune disease and transplant rejection. TX200 targets HLA-A2, an antigen that is commonly mismatched in transplantation procedures. The anticipated clinical trial will investigate the potential of TX200 to prevent graft rejection in kidney transplants. Results from preclinical studies suggest that human HLA-A2 CAR-Treg cells inhibit graft rejection in a mouse model without disrupting the normal suppressive actions of endogenous Treg cells (J. Clinical Invest. 126, 1413–1424, 2016). Sangamo intends to use its expertise in zinc finger nuclease gene-editing technology to develop next-generation CAR-Treg therapies to improve persistence and safety, and to use different target antigens to investigate CAR-Treg cells in multiple sclerosis and Crohn's disease. But given the side effects and huge costs developers have incurred to bring anticancer CAR-T therapies to market (Nat. Biotechnol. 36, 291–292, 2018) the company will likely have to overcome even greater hurdles to move CAR-Treg cells into patients with non-life-threatening disorders, which will also require larger clinical trials.